Our Equality, Diversity and Inclusion (EDI) Network is making strides in promoting inclusivity, dismantling biases and forging a path towards a truly diverse College. However, we are determined to go even further. Our vision is to become an influential force in shaping a more equitable landscape for pathology practice and healthcare (Box 1).
Box 1. What does equality, diversity and inclusion mean to us?
| How we interpret equality, diversity and inclusion | The benefits we foresee for our college, its staff and the membership |
|---|---|
| Equality: Treating everyone fairly, providing equal opportunities and eliminating discrimination | Attracting and retaining diverse talent Increasing morale Improving communication and trust Enhancing reputation Reducing disparities in access, contribution and engagement |
| Diversity: Embracing and valuing everyone's differences and welcoming individual perspectives | Promoting professional development and learning Expanding knowledge and understanding of EDI Encouraging cultural competency Fostering innovation and creativity Enhancing decision-making Improving the design, delivery and impact of programmes and projects |
| Inclusion: Creating a welcoming and respectful environment where diverse individuals can fully participate and contribute |
Creating projects and programmes that reflect the needs of all |
The EDI Network
In 2021, the Trustee Board commissioned the EDI Network to provide advice to the College on matters of equality, diversity and inclusion. The Network is chaired by the President of the College. Katherine Timms, the College’s Director of Professional Practice, co-chairs, representing College staff. In September 2022, Professor Anna Maria Geretti was appointed as co-chair to represent College members.
The Network currently has a membership of 48 people from a diverse professional background brings together people with different characteristics, at different career stages, both within and outside the medical and scientific community.
With this solid foundation in place, the Network is committed to its transformative mission and to taking a proactive approach to drive change.
It brings together people with different characteristics, at different career stages, both within and outside the medical and scientific community. With this solid foundation in place, the Network is committed to its transformative mission and to taking a proactive approach to drive change (Box 2).
Box 2. The EDI Network mission statement
- Foster a dynamic, open and welcoming forum for discussing EDI matters relating to the College's work and pathology practice.
- Ignite a cultural shift by seizing opportunities to promote EDI principles.
- Provide expert guidance to empower the Trustee Board, Senior Management and College Council in promoting EDI principles across the Board and the Council and within College committees and working groups.
- Embrace the richness of diverse backgrounds and identities and actively foster inclusivity throughout the College for our members and staff.
- Drive innovative proposals to enhance EDI within the College.
- Serve as a trusted source on how EDI impacts pathology practice.
- Forge impactful partnerships with influential networks and organisations to advance EDI at the College and within pathology practice.
- Engage and inspire members through captivating social media, emails and articles showcasing the Network's impactful work.
Our achievements
Consensus statement on EDI principles
The EDI Network will soon release a consensus statement to highlight our commitment to promoting equality, diversity and inclusion across our present and future staff, membership and stakeholders. We address the College Trustee Board, Council and College committees and working groups and ask them to consider how their composition, working style and patterns, decisions and recommendations adhere to EDI principles.
We also encourage them to develop corrective plans when issues are identified that may impact the College’s staff or members, and offer the EDI Network’s support towards these actions.
Our commitment doesn't end here. We plan to monitor engagement and adoption closely, requesting regular reports to ensure our efforts are making a real impact.
Tips for organising and running inclusive meetings
The EDI Network will soon release a comprehensive set of tips and recommendations for event organisers, whether their event takes place at the College or at an external location. The guidance reflects our core mission of promoting EDI principles in event planning, with a strong focus on inclusivity, innovative engagement, accessibility and sustainability.
Our aim is to inspire event planners to proactively consider how EDI principles will be applied, factoring in the event type and location and overall feasibility. Some of the key recommendations include striving for gender balance and considering other EDI characteristics when assembling committees and selecting speakers and panellists.
We encourage hybrid formats, remote live presentations and creative methods to facilitate accessibility, participation and engagement.
Additionally, we emphasise the crucial role of event chairs in actively promoting inclusivity throughout the event.
To further support EDI principles, we encourage event organisers to guide presenters in creating accessible presentations and to emphasise the importance of upholding EDI principles in language and materials.
Our journey continues. We will develop guidance for speakers on creating accessible presentations. We will monitor events organised and hosted by the College, identifying further areas for enhancement. We invite you to join us in this collective effort to ensure the events embody our transformative values.
Recent initiatives
Laboratory reference ranges for individuals receiving gender-affirming hormones
The diagnosis of gender dysphoria and access to gender-affirming hormones (from age 16) and surgery (from age 18) are under the purview of the NHS.1
Gender affirmation encompasses multiple domains, including psychological, social, legal, medical and surgical aspects. While transgender individuals may choose to pursue or not pursue medical interventions as part of their journey, understanding the size of the transgender population is crucial to ensure we address their healthcare needs.
Box 3. England and Wales census 2021. Voluntary question for people aged 16 years and above: ‘Is the gender you identify with the same as your sex registered at birth?’
Among the 45.7 million individuals who responded to the question (representing 94% of the population
aged 16 years and above), 262,000 (0.5%) answered ‘No’.
Within the group that answered ‘No’, half did not specify a particular gender identity. Among those who provided information, an equal number (48,000) identified as transgender men or transgender women; 30,000 did not identify with either category.
In terms of regional distribution, within England, London had the highest percentage reporting their gender identity as different from their sex assigned at birth; the South West of England had the lowest percentage.
In the USA, approximately 0.6% of individuals aged 13 years and above identify with a gender identity different from their sex assigned at birth (Figure 1).2 This includes 39% transgender women, 36% transgender men and 25% who self-describe as gender-nonconforming.
In England and Wales, the 2021 census introduced a voluntary question on gender identity for individuals aged 16 and above (Box 3).3 The census question served the purpose of gathering information for monitoring purposes and in support of antidiscrimination duties under the Equality Act 2010. Additionally, it aimed to aid allocation of resources and policy development.
In line with these objectives, the College has formed a working group to examine the impact of gender-affirming hormone therapies on laboratory reference ranges. The primary goal of this initiative is to provide guidance for pathology practice on the interpretation of results, ensuring safe and equitable healthcare provision for transgender individuals.
Masculinising hormone therapy commonly involves using testosterone, while feminising hormone therapy may include oestradiol, an anti-androgen like spironolactone or cyproterone acetate, and possibly progesterone.
Within 3 months of initiating gender-affirming hormone therapy, significant changes occur in sex-steroid concentrations, body composition and common laboratory values.
It is important to interpret laboratory tests with sex-specific differences correctly (e.g. liver enzymes, creatinine, estimated glomerular filtration rate, haemoglobin and haematocrit).
Engaging our community is a challenge we recognise
Despite our efforts to gather insights on EDI through a recent survey, we encountered a challenge with a response rate of only 4%. It isn’t unusual for organisations to receive low response rates when they first seek EDI data, but even so this number is exceptionally small. Without comprehensive data, our capacity to take informed action, address specific needs and implement effective initiatives is much constrained.
We are unable to analyse and report on the data in a meaningful way. We are also facing a challenge with a lack of volunteers to organise and run awareness days, which aim to recognise diverse groups publicly and celebrate with them through the year.
Call to action
We invite you to make a positive impact towards a more inclusive and equitable environment. Your input is vital for shaping meaningful change.
We encourage you to participate in future surveys to provide the essential data we require to take effective action and drive impactful progress.
As we progress work on our strategy document for 2024 onwards, we welcome your views and input. We ask you to offer your enthusiasm, time and expertise to initiatives that relate to promoting EDI principles within the College and more broadly within pathology practice and healthcare. Your participation will enrich our community. Together we can make a difference.
Author(s)
Professor Anna Maria Geretti, MD, PhD, FRCPath
